07.09.2014

#FullRepeal Daily Digest

Investors Business Daily: 3 Obamacare Funding Cliffs Imperil Coverage, Access [Obamacare supporters terminated funding for these three priorities to make the bill score better. This may present an opportunity to preemptively call them out for misleading the American people and to demand we stop funding a law we cannot afford and that the American people don't want. Inevitably, Democrats will try to wait until the last minute when Republicans have their hands "forced" to re-up these expiring spending streams.]

The first bumps could be felt at the start of 2015, when the Affordable Care Act's boost in funding for Medicaid primary care doctors is set to expire. The law temporarily provided funds to lift Medicaid's reimbursement rates, putting them on par with Medicare's for 2013 and 2014 at a cost of $11 billion.
The White House has proposed spending an extra $5.4 billion in calendar-year 2015 to extend higher Medicaid reimbursements for primary-care doctors and broaden eligibility to include physician assistants and nurse practitioners…Congress has stepped up to prevent a similar plunge in Medicare reimbursements, avoiding the ire of politically powerful seniors as well as doctors. But it's unclear whether Medicaid rates will enjoy the same protection. Beyond the challenge of finding offsetting cuts (or extra revenue), the GOP would have to forfeit leverage to demand more far-reaching changes to a law that its members oppose.
[the 2nd cliff] ObamaCare provided $11 billion over five years to boost the capacity of community health centers, a key source of care in low-income, medically underserved areas. Most of the money goes to clinics where reimbursements and co-pays often don't cover the cost of care.
A third upcoming cliff would see funding for the Children's Health Insurance Program, or CHIP, sink from $12.5 billion in fiscal 2015 to $9.1 billion the next year and $5.7 billion thereafter.As the Kaiser Family Foundation explained, the bulk of CHIP financing was set to expire after 2015 "to reduce costs for the ACA (Affordable Care Act) in the CBO score" of the law.
The thinking back in 2009 may have been that children in families earning too much for Medicaid could go from CHIP into subsidized coverage via the ObamaCare exchanges. But an IRS regulation could put affordable coverage out of reach for 1.9 million children covered under CHIP, the Government Accountability Office (GAO) has estimated.

Mercury News: Anthem Blue Cross accused of 'fraudulent' enrollment practices

California insurance giant Anthem Blue Cross misled "millions of enrollees" about whether their doctors and hospitals were participating in its new "Obamacare" plans and failed to disclose that many policies wouldn't cover care outside its approved network, according to a class-action lawsuit filed Tuesday.
The suit says that Anthem, the state's largest individual health insurer, delayed providing full information to consumers until it was too late for them to change coverage. The suit also alleges that Anthem failed to disclose it had stopped offering any plans with out-of-network coverage in four of the state's biggest counties -- Los Angeles, Orange, San Francisco and San Diego.
Anthem spokesman Darrel Ng said that Anthem has agreed to pay the claims of those who received treatment from inaccurately listed doctors during the first three months of the year. However, he said, that policy would not be extended for enrollees who discovered after March 31 that their doctors had been incorrectly listed.
Los Altos Hills residents Steven and Kathleen Moore were "fraudulently induced" into buying a Blue Cross "no deductible plan" that purported to include the family's regular physicians, the suit says. In actuality, the suit adds, the plan imposed a $10,000 deductible for out-of-network providers and none of the physicians were included in the new limited network.
Fred Crary, of San Jose, a longtime but now former Anthem Blue Cross customer, said he's not a fan of lawsuits. "But this is so important to families that I think it's a good step that (Consumer Watchdog) is taking," said the 59-year-old retired Silicon Valley tech executive.

The New York Times: Democrats Push Bill to Reverse Supreme Court Ruling on Contraceptives

The bill would ensure that women had access to insurance coverage for birth control even if they worked for businesses that had religious objections. The bill, put together in consultation with the Obama administration, would require for-profit corporations like Hobby Lobby Stores to provide and pay for contraceptive coverage, along with other preventive health services, under the Affordable Care Act.
The measure could be on the Senate floor as early as next week, Senate Democrats said…Senator Patty Murray, Democrat of Washington, who led efforts by Senate Democrats to respond to the ruling, said: “Your health care decisions are not your boss’s business. Since the Supreme Court decided it will not protect women’s access to health care, I will.”
[Harry Reid said] "The one thing we’re going to do during this work period, sooner rather than later, is to ensure that women’s lives are not determined by virtue of five white men,”

Modern Healthcare: More than half of companies considering private exchanges, survey finds

More than half of the companies surveyed indicated that they are considering sending their employees to private insurance exchanges to purchase subsidized coverage. That includes 28% that reported they are very likely to move to a private exchange model or have already done so, and 25% that are somewhat likely to embrace such a change. In addition, nearly a quarter of respondents, 23%, indicated that they are very likely to eliminate healthcare coverage altogether, or have already done so, and instead direct employees to the public exchanges.
The willingness to consider major changes to healthcare benefits is almost certainly rooted in concerns about cost. More than half of the companies surveyed, 54%, cited controlling healthcare costs as a top priority. That was higher than any other benefits-related concern cited by respondents. In addition, 29% of company finance officials indicated that minimizing the impact of rising healthcare costs on employees was a major concern. Premiums for employer-based coverage have increased by 80% over the last decade, according to the Kaiser Family Foundation.
However, few employers expect to shield their workers from the rising cost of healthcare. Four out of five respondents indicated that they have either already shifted more costs onto employees (22%) or that they anticipate doing so (58%).

Politico Pulse: SOCIAL SECURITY NUMBERS EXPOSED

Blue Shield of California has inadvertently released the Social Security numbers of 18,000 physicians and other providers, the health insurer said earlier this week. The numbers were available under the state’s public records law after the company included them in filings to the state but neglected to mark the rosters as confidential. They were released 10 times as a result of public records requests from other insurance companies, their attorneys and two members of the media.

Politico Pulse: OBAMACARE INVOICES MIXED UP

Ruh-roh. Washington Healthplanfinder is having some troubles with its August invoices, according to an FAQ posted on the exchange’s website. Some customers are getting invoices that claim they owe twice as much as they normally pay for their monthly premiums. Others are told they owe $0. Some customers aren’t getting invoices at all, while others who cancelled coverage are still receiving them. The exchange is instructing the customers to reselect their plan in order to apply any recent tax credit changes. It says it’s working hard to resolve these issues, but warns customers that the deadline to pay August premiums is July 23. The FAQ: http://bit.ly/1vXO3bc